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The Employee Retirement Income Security Act (ERISA) became a federal law in 1973. ERISA established minimum standards for private health and retirement plans. While employers are not required to provide health and retirement benefits, they must comply with ERISA regulations when they voluntarily do so. 

If you’re a New York City employee and your employer is preventing you from accessing your retirement or health benefits, you may have a right to pursue an ERISA claim. The process for recovering remedies through an ERISA claim is different than through a standard civil lawsuit. For example, you won’t be able to file a civil lawsuit unless you’ve exhausted all administrative remedies. The attorneys at Lipsky Lowe LLP are prepared to handle every aspect of your claim while pursuing all of the remedies you deserve.

What Is ERISA?

ERISA was enacted into federal law to protect employee benefits from unscrupulous companies. Specifically, ERISA regulates the benefits funded and paid by insurance companies, preventing insurance companies from delaying, denying, and terminating claims. ERISA requires for-profit employee benefits providers to:

  • Set minimum participation standards for retirement and health benefit plans
  • Disclose plan information to participants, including funding and plan features
  • Disclose fiduciary duties
  • Establish a process for employees to report grievances
  • Allow employees to pursue a claim for violations without retaliating against them

ERISA only regulates for-profit organizations, including private organizations offering qualifying health, retirement, and profit-sharing plans. Government agencies, non-profit organizations, and qualifying religious organizations are not subjected to ERISA laws. The federal government uses three main agencies to enforce ERISA regulations:

  • The Internal Revenue Service (IRS)
  • The Employee Benefits Security Administration (EBSA
  • The Pension Benefit Guaranty Corporation

Types of ERISA Claims We Handle

If your employer has engaged in an ERISA violation, whether intentionally or unintentionally, Lipsky Lowe LLP is here to help you navigate this complex area of law. ERISA violations can occur at any stage of the business. A start-up company could engage in ERISA violations while implementing startup procedures. An established company may have initially been in compliance with ERISA but may fail to keep up with ongoing requirements. We have decades of experience handling the following types of ERISA matters:

  • Claims submissions
  • Claims management
  • Appealing denied or terminated claims
  • Negotiating settlements
  • Lawsuits or litigation

Failing to Disclose Information

Employers are required to disclose important plan information to participants. They must disclose temporary plan changes, such as reduced funding, along with long-term plan changes. ERISA sets the timeframes within which employers must notify employees of changes. 

Plan Administrators Cannot Breach Their Fiduciary Duties

Plan administrators are required to prompt the interests of the participants and beneficiaries. Plan administrators can be held responsible through an ERISA claim when they breach their fiduciary duty. Failure to follow the established fiduciary guidelines is also considered a punishable violation. 

Denying Benefits to an Employee

It’s incredibly frustrating for employees whose injuries may be instantly recognizable by the employees and his or her doctors but with symptoms that may not be as obvious. Employers offering qualifying plans should provide benefits to their employees as they’re laid out. If an employer denies a qualifying employee a benefit to which the employee is entitled, the action will be considered an ERISA violation. Unfortunately, insurance companies frequently use any method possible to deny disability claims. 

For many employee policyholders, denied claims for disability can be earth-shattering. When employees become sick or injured to the extent that their regular income has decreased or stopped altogether, they need their disability benefits the most. Unfortunately, pursuing a claim through ERISA can be an uncharted and complex territory for many New York employees. 

The attorneys at Lipsky Lowe LLP have the experience and skills needed to gather evidence showing the impact your disability has on your ability to work. We will work with medical experts to prove, in detail, all of the limitations and pain caused by your disability. Lipsky Lowe LLP knows how to hold insurance companies accountable for unfairly denying or limiting disability claims. 

Employers Cannot Retaliate Against Employees for PUrusing an ERISA Claim

ERISA, which protects employees from retaliation for pursuing a claim, as with other employee rights laws. Employers cannot take any adverse action against an employee for requesting more information about their benefits or for pursuing an administrative or civil claim. For example, employers cannot fire or demote an employee for pursuing an ERISA claim.

The Penalties for Violating ERISA

ERISA violations can result in civil or criminal charges depending on the type and extent of the violation. Before employees can pursue a civil lawsuit against an employer for an ERISA violation, he or she will need to file an administrative appeal first. Courts can award successful plaintiffs compensation for their unpaid contributions, interests on unpaid contributions, and attorney’s fees and costs. 

Courts also have the authority to levy fines on the employer as they deem fit. Guilty individuals can face up to ten years in prison when employers are found to have committed a criminal violation of ERISA, such as the fraudulent manipulation of information to deny benefits. Guilty individuals can face a fine of up to $100,000. Companies face fines of up to $500,000.

Helping Employers Comply with ERISA

ERISA regulations and procedures are continually changing, as with any other federal employment law. Companies should ensure their practices remain compliant by revising their plan documents and effectively communicating changes to their employees. The penalties for violating ERISA regulations are significant, and you could face criminal charges. Lipsky Lowe LLP regularly works with New York City businesses to review their employee benefits policies. We will identify any red flags and help you bring your business into compliance. 

Contact an ERISA Attorney in NYC

If your employer has violated your ERISA rights, don’t hesitate to contact the New York City employment attorneys at Lipsky Lowe LLP. We have extensive experience pursuing employees’ rightful benefits through ERISA and will guide you through the complex process of recovering the remedies you deserve. We also help businesses come into compliance with ERISA.